Martha’s Rule Rolled Out Across All A&E Departments in England: What Patients Need to Know
A patient safety initiative introduced following the death of 13-year-old Martha Mills is now being rolled out across all Accident and Emergency (A&E) departments in England, giving patients and families a clearer route to raise concerns about care when they feel those concerns are not being listened to.
Known as Martha’s Rule, the initiative aims to improve patient safety in NHS hospitals by ensuring concerns about a patient’s deteriorating condition can be escalated quickly and appropriately.
The announcement that Martha’s Rule will be available across all A&E departments in England represents a significant development in patient safety and communication within the NHS.
What is Martha’s Rule?
Martha’s Rule was introduced after the death of Martha Mills in 2021. Martha died from sepsis while in hospital after suffering a pancreatic injury. An inquest found that her parents’ concerns about her deteriorating condition were not adequately addressed and that earlier escalation of those concerns may have changed the outcome.
The initiative gives patients, families and carers a direct route to request an urgent review by another clinical team if they are concerned that a patient’s condition is deteriorating and their concerns have not been addressed. The aim is to provide an additional layer of protection for patients, helping to ensure potential signs of clinical deterioration are identified and acted upon as early as possible.
Why Is Martha’s Rule Important?
Family members and carers are often the people who know a patient best. They may notice subtle changes in a person’s condition before clinical signs become obvious.
While healthcare professionals work hard to provide safe and effective care, communication can sometimes break down, particularly in busy hospital environments. Martha’s Rule seeks to promote a culture where concerns are listened to, acknowledged and acted upon appropriately.
The wider rollout across A&E departments reflects a growing recognition of the importance of patient and family voices in healthcare decision making and the role effective communication can play in improving patient outcomes.
How Does Martha’s Rule Work?
Martha’s Rule gives hospital patients, their families and carers the right to request an urgent review if they are worried that a patient’s condition is getting worse and they feel their concerns are not being listened to.
Step 1: Speak to the Clinical Team
If you are concerned about your own condition or that of a loved one, raise your concerns with the doctors, nurses or healthcare professionals responsible for their care.
Step 2: Escalate Your Concerns
If, after speaking to the care team, you remain worried and feel your concerns have not been adequately addressed, you can request a rapid review under Martha’s Rule.
Step 3: Request a Rapid Review
Each NHS Trust has its own process, usually involving a dedicated telephone number or contact service. This allows a different clinical team, often a Critical Care Outreach Team, to review the patient’s condition.
What Happens After a Martha’s Rule Review?
The reviewing team will assess the situation, consider the concerns raised, and decide whether further tests, treatment, monitoring or specialist input are required. This additional review process is designed to help ensure concerns regarding patient safety and clinical deterioration are fully considered.
When Can Martha’s Rule Be Used?
Examples might include:
- A patient appears to be getting worse.
- Symptoms are changing unexpectedly.
- Family members feel concerns are not being taken seriously.
- There is confusion about a patient’s condition or treatment plan.
- A patient feels their deterioration is not being recognised.
Martha’s Rule is intended as a patient safety measure and is not a complaints procedure or a route to obtain a second opinion on treatment choices. Its purpose is to ensure concerns about clinical deterioration are heard and acted upon quickly.
Why Listening to Patient Concerns Matters
Research and investigations into patient safety incidents have repeatedly highlighted the importance of effective communication between healthcare professionals, patients and families.
Many complaints arising from medical treatment are not solely about clinical outcomes. Patients frequently report feeling excluded from decisions regarding their care, unsure about treatment plans, or concerned that their worries were not taken seriously.
Initiatives such as Martha’s Rule are intended to encourage open communication and provide reassurance that concerns can be escalated when necessary.
Where concerns about medical treatment have not been appropriately addressed, patients and their families may wish to seek specialist advice regarding potential medical negligence claims.
When Should You Seek Advice About Medical Care?
Not every unexpected medical outcome is the result of negligence. However, concerns may arise where there are questions about delays in diagnosis, failures to recognise deterioration, communication issues, or whether appropriate treatment was provided.
A detailed review of the medical records and independent expert evidence is usually required before any conclusions can be reached about the standard of care provided.
Cases involving delayed diagnosis, failures to recognise deterioration, communication failures or hospital treatment errors often require specialist legal and medical assessment before liability can be established.
How Our Medical Negligence Team Can Help
Experiencing unexpected complications during medical treatment can be distressing for both patients and their families. If you have concerns about the care you or a loved one has received, our specialist Medical Negligence team can listen to your concerns and advise whether there may be grounds for further investigation.
Our experienced Medical Negligence Solicitors advise clients in relation to delayed diagnosis, failures to recognise deteriorating conditions, hospital treatment errors and other forms of clinical negligence.
For a free, no-obligation discussion, please contact our team on 0800 987 8800 or email enquiries@bmcf.co.uk.
